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COASTAL REHABILITATION LLC - Florida Company Profile

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Company Details

Entity Name: COASTAL REHABILITATION LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 11 Oct 2023 (2 years ago)
Document Number: L23000467744
FEI/EIN Number 93-3871234
Address: 7113 LAGOON DRIVE, PANAMA CITY BEACH, FL, 32408, US
Mail Address: 7113 LAGOON DRIVE, PANAMA CITY BEACH, FL, 32408, US
ZIP code: 32408
City: Panama City
County: Bay
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
LANCE JORDAN S Manager 7113 LAGOON DRIVE, PANAMA CITY BEACH, FL, 32408
LANCE JORDAN S Agent 7113 LAGOON DRIVE, PANAMA CITY BEACH, FL, 32408

National Provider Identifier

NPI Number:
1881420917
Certification Date:
2025-05-06

Authorized Person:

Name:
SANDI GAY
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
8502482469
Fax:
8503734858

Documents

Name Date
AMENDED ANNUAL REPORT 2024-05-21
ANNUAL REPORT 2024-03-12
Florida Limited Liability 2023-10-11

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Date of last update: 02 Aug 2025

Sources: Florida Department of State